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Int Urol Nephrol. 2013 Apr;45(2):347-54. doi: 10.1007/s11255-013-0399-x. Epub 2013 Feb 16.

Grading complications after transurethral resection of prostate using modified Clavien classification system and predicting complications using the Charlson comorbidity index.

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Department of Urology, Chhatrapati Shahuji Maharaj Medical University, (Formerly, King George Medical College), Lucknow, India.



To retrospectively report and grade the peri-operative complications of transurethral resection of the prostate (TURP) using the modified Clavien classification system (MCCS) and validate whether Charlson comorbidity index (CCI) predicts the complications after TURP.


Between September 2006 and 2012, data of 722 patients who underwent TURP were analyzed after excluding patients with incomplete data (n = 40). Data recorded included the age, prostate volume, operative time, mean prostatic tissue removed and duration of hospitalization while complications were recorded using the MCCS. Preexisting comorbidities were evaluated using the CCI, and patients were classified into 3 CCI score categories (0, 1, ≥ 2).


Two hundred and forty-four complications were seen in 145 (20 %) patients. CCI score was "0" for 480 patients (66.5 %), "1" for 184 patients (25.5 %) and "≥ 2" for 58 patients (8 %). Significant difference was observed between patient groups with CCI score 0, 1 and ≥ 2 for mean age, prostatic weight, operative time, weight of prostatic chips and duration of hospitalization. Similarly, a significant difference in occurrence of various MCCS grades of complication among patients groups with different CCI score was observed.


Grades I, II and III complications constituted the main bulk (90 %) while grade IV were less common (<8 %) and grade V was rare (1 %) after TURP. Men with higher CCI score had a significantly higher rate of morbidity than those with a lower score. The present study is the first to validate that CCI can predict complications of TURP recorded according to the MCCS.

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